沙特阿拉伯一家三级医院根据住院病人的抗菌药物敏感性结果确定经验性使用抗生素的适当性

Yasser Almogbel, Mugahid A. Mobark, Masaad S. Almutairi, Faisal S. Almogbel, Syed I. Rabbani, Sultan Alhathloul, Shada Alamro, Lateefah Alatallah
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引用次数: 0

摘要

抗生素的优化使用是控制抗生素耐药性的基石。抗生素监管计划(ASPs)等策略的制定旨在影响抗生素的合理使用。本研究评估了根据抗生素药敏结果经验性使用抗生素的适当性,目的是有效参与改进当地的 ASP。在沙特阿拉伯一家三级医院进行的横断面研究中,500 名住院病人接受了经验性抗生素治疗,其培养和药敏结果均被纳入研究范围。根据培养和药敏结果确定经验性使用抗生素的适当性。半数以上(56.4%)的参与者为男性,近一半(43%)的参与者年龄在 61 岁以上。58%的患者在经验性使用抗生素时处方得当。环丙沙星和头孢曲松是处方量最大的抗生素,而万古霉素、哌拉西林-他唑巴坦和替加环素则是处方量最适当的抗生素。大肠杆菌是药敏结果中分离出的主要微生物,59%的患者可适当处方大肠杆菌。利奈唑胺、万古霉素和替加环素的微生物敏感性最高。半数以上的参与者在经验处方中使用了抗生素。启动介入性 ASP 对于填补抗菌药物处方的空白至关重要。考虑到预期的生物类型和当地的药敏模式,很可能会更恰当地根据经验使用抗生素。
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The Appropriateness of Empirical Uses of Antibiotics Based on Antimicrobial Susceptibility Results for Inpatients at a Tertiary Hospital in Saudi Arabia
The optimal use of antibiotics represents a cornerstone in controlling antibiotic resistance. Strategies such as antibiotic stewardship programs (ASPs) have been developed to influence the rational use of antibiotics. This study evaluated the appropriateness of the empirical use of antibiotics based on antibiotic susceptibility results with the aim of participating effectively in improving local ASPs. In a cross-sectional study conducted at a tertiary hospital in Saudi Arabia, 500 inpatients received empirical antibiotics, and their culture and sensitivity results were included. The appropriateness of the empirical use of antibiotics was determined based on their alignment with the culture and sensitivity results. More than half of the participants (56.4%) were men, and nearly half (43%) were over 61 years old. The empirical uses of antibiotics were appropriately prescribed in 58% of the patients. Ciprofloxacin and ceftriaxone were the most prescribed antibiotics, while vancomycin, piperacillin–tazobactam, and tigecycline were the most appropriately prescribed antibiotics. E. coli was the main microorganism isolated in the susceptibility results and was appropriately prescribed in 59% of the patients. The highest microbial sensitivity was observed for linezolid, vancomycin, and tigecycline. Antibiotics were appropriately prescribed empirically in more than half of the participants. Activating interventional ASP is crucial to fill the gap in prescribing antimicrobials. Considering the expected type of organisms and the local susceptibility pattern is likely to yield a more appropriate empirical use of antibiotics.
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